Provider Demographics
NPI:1548870041
Name:VOLGMAN-MERCURI, MICHAEL JOSEPH
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:VOLGMAN-MERCURI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 WINKLER TRL
Mailing Address - Street 2:
Mailing Address - City:COLOGNE
Mailing Address - State:MN
Mailing Address - Zip Code:55322-8013
Mailing Address - Country:US
Mailing Address - Phone:320-309-2829
Mailing Address - Fax:
Practice Address - Street 1:1011 MEADOWLANDS DR STE 1&2
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55127-2339
Practice Address - Country:US
Practice Address - Phone:507-322-7752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other